609例城乡育龄妇女人工流产现状及其影响因素的研究

对６０９例城乡育龄妇女的人工流产现状进行了调查。结果发现,６０．５９％的城乡育龄妇女有人工流产史１８．３９％的妇女有婚前人工流产史。人流次数最多的７次,婚前人流次数最多达７次。多因素线性回归分析发现,妇女妊娠次数、生育次数、丈夫的年龄、妇女结婚时的年龄、性伴数等是影响妇女人工工流产的主要危险因素。研究提示,加强育龄妇女的生殖健康知识教育,减少婚前性行为和意外妊娠的发生率,降低人工流产率对保护妇女生     

药物流产相关因素分析

目的：探讨影响药物流产的相关因素。方法：以门诊经妇科检查，验尿HCG及B超确定妊娠，且为停经≤49天的健康妇女，自愿要求行药物流产、无禁忌症健康妇女258例为观察对象，观察药流与本次孕龄、年龄、胎次、产次及人工流产史等因素的相关性。结果：药物流产效果与本次孕龄、年龄、胎次、产次及人工流产史有关，差异有统计学意义（P〈0．05）。妇科医生指导药流时，并非越早效果越好，尤其对≤39d的孕妇。结论：应综合考虑上述因素对药流效果的影响，以减少药流并发症，保护育龄妇女的生殖健康。     

2495例人工流产现状分析

目的:了解自愿进行人工流产妇女的一般情况及妊娠情况,为更好地开展人工流产的综合治理提供科学依据。方法:对2012年1~12月在南京军区南京总医院妇产科实施人工流产的2 495例孕妇的临床资料进行回顾性分析。结果:人工流产妇女年龄以婚育高峰期(20~34岁)为主,首次727例,1~3次流产妇女占全部人工流产数的80.72%,而且多在20~35年龄组,上半年高于下半年。结论:加强对育龄妇女避孕知识的宣传和措施的落实,重点加强首次流产临床和术后的生殖健康教育,切实做好未婚女性的性教育,避免未婚先孕,未婚流产,减少流产次数,保护育龄妇女的身心健康是当前社会的重要任务。     

初孕药物流产对再次妊娠的影响

目的 探讨药物流产对再次妊娠的影响。方法 采用回顾性调查方法,对 268例有药物流产史的初孕妇女,623例有人工流产史及329例无流产史的初孕妇女进行对照分析。结果 药物流产组胎盘粘连和产后出血的发生率低于人工流产组(P<0.05),胎盘粘连、产后出血、先兆流产和早产的发生率高于无流产组(P<0.05)。结论 药物流产是比人工流产安全的避孕失败补救措施。但药物流产后再次妊娠并发症增加。     

初孕不同流产方式对再次妊娠母婴结局影响的研究

目的探讨药物流产或人工流产（刮宫术）对再次妊娠及母婴的影响。方法将初孕有一次药物流产史的健康孕妇120例分为A1组,初孕〉1次药物流产史的健康孕妇70例分为A2组,初孕有一次人工流产（刮宫术）史的健康孕妇120例分为B1组,初孕〉1次人工流产（刮宫术）史的健康孕妇60例分为B2组,孕前无流产史的健康孕妇随机选择120例分为对照组C,分析3组孕妇病例随访资料。结果除先兆流产外,药物流产组与对照组再次妊娠的孕期,围生期及新生儿情况差异均无统计学意义（P〉0.05）,与人工流产组相比,药物流产组与对照组胎盘粘连、胎盘残留、胎盘植入和产后出血发生率均较低（P〈0.05）。一次以上人工流产组胎盘植入,胎盘粘连和早产发生率明显高于1次人流组（P〈0.05）,而药流组妊娠并发症的发生率与药流次数无明显关联。结论药物流产对再次妊娠母婴的影响小于人工流产,相对更安全,为中止非意愿妊娠首选,但仍可能引起某些并发症,人工流产后再次妊娠并发症发生率与人工流产次数有关,因此仍要大力普及避孕知识,提倡安全妊娠和分娩。     

育龄妇女重复人工流产状况及影响因素分析

目的:分析育龄妇女重复人工流产现状、影响因素及最近一次分娩或流产后避孕情况,探讨降低重复人工流产率的政策和措施。方法:应用2017年全国生育状况抽样调查数据,选取调查前60个月内即2012年7月以来有妊娠经历的育龄妇女作为研究对象,采用多因素logistic回归分析。结果:育龄妇女重复人工流产率为31.3%,年龄大、受教育程度低、未婚同居、非农就业、西部地区育龄妇女是重复人工流产的高风险人群,最近1次分娩或流产后使用避孕措施者仅占76.6%,其中59.2%采用短效避孕措施。结论:育龄妇女重复人工流产率高,应重视育龄妇女的避孕节育工作,关注重点人群,做好流产后关爱工作。     

城市已婚育龄妇女人工流产史及避孕知识态度和行为现况研究

目的了解育龄妇女的人工流产史及其原因和有关避孕的知识、态度和行为现状,探讨如何提高避孕知识知晓率和改善相关的态度和行为,以及减少避孕失败的措施.方法采用整群抽样的方法对776例年龄为15～49岁的城市已婚育龄妇女进行有关人工流产和避孕知识、态度和行为的问卷调查和妇女常见疾病检查,数据应用SPSS/PC 10.0软件进行统计分析.结果81.9%的妇女有人工流产史,其中人工流产3次及以上者达13.8%;有人工流产史的妇女其子宫内膜异位症或子宫腺肌病、痛经和慢性盆腔炎的患病率明显高于无人工流产史者(P＜0.01或P＜0.05);54.8%的人不知道任何一种避孕方法的避孕原理;有49.73%的妇女不知道人工流产手术对身体健康有不良影响;83.5%的人不知道有紧急避孕法.结论迫切需要加强有关避孕知识的健康教育,并将其作为提供优质生殖健康服务的内容,以降低人工流产率.     

南京市浦口区育龄妇女人工流产流行病学调查

目的:了解南京市浦口区育龄妇女人工流产的人口学特征、人工流产方式及其原因.方法:在自愿的前提下,以匿名方式随机抽取578例人工流产的育龄妇女进行问卷调查.结果:51.6%人工流产者为已婚妇女,年龄主要在20～29岁;55.2%的人选择无痛吸刮宫方式,53.5%的人有过1次以上的人流史;48.5%的人是因避孕失败而致孕;婚姻状况不同,未避孕原因不同,避孕失败类别也不同.结论:应加强流产后避孕指导,并在广大育龄妇女中大力开展健康教育,加强避孕知识和流产危害性的宣传教育,提高自我保健意识和能力,特别是对未婚和流动人口的育龄妇女要反复强化宣传.     

流动人口人工流产妇女实施综合性服务的观察

目的探讨流动人口人工流产后的健康教育和选择安全、有效、适宜的避孕节育措施,以提高计划生育服务质量、保障流动育龄妇女生殖健康。方法对本院2008年5月~2009年5月收治的200例流动人口人工流产妇女,随机分成观察组和对照组,观察组：在人工流产前提供与生殖健康相关的综合咨询服务;（2）流产后避孕知识宣教,发放宣传卡片,讨论选择避孕措施。对两组人工流产妇女均开展流产后跟踪电话随访,完善服务记录。结果随访率：观察组81%,对照组72%;非意愿妊娠：观察组占4.9%,对照组占34.7%;重复流产：观察组占2.4%,对照组占12.5%,两组比较差异有统计学意义。结论通过推广干预措施可以有效地提高流动人口的生殖健康知识和自我保健知识,保障了流动育龄妇女的生殖健康。     

"人流"保健手册

流产是女人不愿面对的事情，然而又往往是不得不面对的现实，几乎大部分女人都会在育龄期有过至少一次流产经历。北京市对近十年人工流产原因作过调查，发现育龄妇女中46％的人至少有过一次流产史，而且造成非意愿怀孕的原因，都是无保护性生活或避孕失败。WHO根据对生殖健康指标估计，全世界每年约有不下5000万妇女无奈地接受人工流产。我国自80年代以来，初步估算每年的人工流产例数都在1000万以上，居高不下。人工流产很可怕WHO公布过这样的资料，估计全球每年发生不安全人工流产达2000万次以上，约有8万妇女因并发症而死亡，数百万人…     

Integrating medical abortion into safe abortion services: experience from three pilot sites in South Africa

BACKGROUND AND METHODOLOGY: South Africa's Choice on Termination of Pregnancy Act of 1996 provides for safe termination of pregnancy (TOP) in designated facilities in the public and private health sectors. In 2001, mifepristone-misoprostol medical abortion was approved for TOP up to 56 days, but this method is not yet available in the public sector. Information on the operational requirements for integrating mifepristone-misoprostol medical abortion into South Africa's public sector safe abortion services is required to guide policy decisions. This study trained health workers to provide medical abortion to 290 women attending three TOP sites. Prospective data were collected to ascertain women's experience of the method, pregnancy outcome, women's and provider's acceptability of the method, and the operational requirements for providing medical abortion. RESULTS: Twenty-nine (10%) women were lost to follow-up; 261 (90%) women had a confirmed abortion outcome, of whom 93% had a complete abortion. Given the option, the vast majority of women opted to use misoprostol at home. No serious side effects were reported; pain (66%), and heavy bleeding (67%) were the most common side effects. Most (96%) women were very satisfied with the experience. Health providers were satisfied with providing medical abortion and recommended its introduction to complement existing surgical TOP services. DISCUSSION AND CONCLUSION: This study demonstrates that integration of medical abortion into public sector services is feasible. The results of this study will guide policy decisions about integrating medical abortion into South Africa's public sector safe abortion services, within the context of the existing enabling legislative framework.     

Risk of ectopic pregnancy and previous induced abortion.

OBJECTIVES: This study investigated the role of prior history of induced abortion in subsequent ectopic pregnancies. METHODS: Data from two French case-control studies were used to examine the effect of induced abortion on ectopic pregnancy risk. Case patients (n = 570) were women admitted for ectopic pregnancy during the study period; controls (n = 1385) were women who delivered in the same center. RESULTS: The analysis among women with no previous ectopic pregnancy showed that, after control for the main ectopic pregnancy risk factors, prior induced abortion was associated with an increased risk of ectopic pregnancy (odds ratio [OR] = 1.5, 95% confidence interval [CI] = 1.0, 2.0); there was a significant trend between number of previous induced abortions and ectopic pregnancy risk (ORs = 1.4 for 1 previous induced abortion and 1.9 for 2 or more). CONCLUSIONS: This study suggests that induced abortion may be a risk factor for ectopic pregnancy for women with no previous ectopic pregnancy, particularly in the case of women who have had several induced abortions.     

广州市未婚流动人口人工流产状况及影响因素分析

目的:了解广州市未婚流动人口人工流产状况及其影响因素。方法:采用随机整群抽样方法进行抽样,应用统一的“外来务工未婚女性生殖健康需求与服务调查问卷”,对调查对象进行现场问卷调查。结果:共调查1872名未婚女性流动人口,有过婚前性行为者233名,发生率为12.4%。69人至少有过1次人工流产,人工流产率为29·9%。在实施过人工流产的人群中,32人(46.3%)的妊娠月份超过2个月,21人(30.4%)选择在家中或私人诊所实施手术。人工流产的发生与调查对象的文化程度、收入情况,对人工流产危害的认识,避孕情况及其了解避孕方法的种类有关。结论:未婚流动人口人工流产的发生率较高,与其认知水平和避孕行为密切相关,为流动人口提供及时有效的生殖健康教育和服务将有助于提高其生殖健康认知水平和行为能力,降低人工流产率及其危害。     

ELICITING QUALITATIVE INFORMATION ABOUT INDUCED ABORTION: LESSONS FROM NORTHEAST THAILAND

Obtaining reliable information about induced abortion is notoriously difficult, especially where abortion is illegal. This article describes methods used in a study of illegal induced abortion among village women in Northeast Thailand. A variety of methods were used to gather in-depth qualitative data on abortion experiences including a randomized interview survey on reproductive health, in-depth interviews with women who had experienced an induced abortion in the last two years, and the use of vignettes in focus group discussions with men and women. The survey provided a broad overview of the extent of the experience of abortion. In-depth interviews through social networks proved more successful for obtaining reliable accounts of abortions and suggest that survey results were underestimates. Focus groups discussed the situational ethics involved in abortion decisions. Within an appropriate context and study design, it is possible to obtain highly sensitive information while respecting the privacy of informants.     

Eliciting qualitative information about induced abortion: lessons from Northeast Thailand

Obtaining reliable information about induced abortion is notoriously difficult, especially where abortion is illegal. This article describes methods used in a study of illegal induced abortion among village women in Northeast Thailand. A variety of methods were used to gather in-depth qualitative data on abortion experiences including a randomized interview survey on reproductive health, in-depth interviews with women who had experienced an induced abortion in the last two years, and the use of vignettes in focus group discussions with men and women. The survey provided a broad overview of the extent of the experience of abortion. In-depth interviews through social networks proved more successful for obtaining reliable accounts of abortions and suggest that survey results were underestimates. Focus groups discussed the situational ethics involved in abortion decisions. Within an appropriate context and study design, it is possible to obtain highly sensitive information while respecting the privacy of informants.     

妊娠妇女选择流产方式的意向调查

本文对要求终止妊娠的早孕妇女进行了流产方式选择调查,探讨现阶段吸宫流产和药物流产两种方法的可接受性。共调查1008例,其中选择吸宫流产者459人,占所调查者的45.54％;选择药物流产者549人,占总数的54.46％。选择流产方法时的心理因素:选择吸宫术者认为手术完全彻底为198人(占吸宫组总数的43.14％),手术结束快190人(占41.39％),上次选择手术终止妊娠的妇女本次仍选择手术的有154人,占上次手术者的43.87％,而改选为药物流产者197人,占56.13％。选择药物流产者认为无痛苦461人(占药物流产组总数的83.97％)。上次选择药物流产的妇女本次仍有142人再次选择药物流产,占上次药物流产的58.44％。本次改选手术的有101人,占41.56％。本项研究中要求流产的未产妇共有222人(占总数的22.02％),其中选择药物流产的有134人(占60.36％),而选择吸宫术的有88人(占39.63％)。由此看来,年轻的未产妇更愿意选择药物流产方式终止妊娠,其主要原因为对手术痛苦的畏惧。选择药物流产妇女中76.90％的对象2年内有流产史,而在手术组占44.32％。两次妊娠间隔时间短,担心手术损伤是她们在做出选择时的主要因素之一。由此看来,有近期流产史的妇女较愿意选择药物流产。综上所述,两种流产方法的可接受性相近,有各自相适应的人群,二者不     

Examining the association of abortion history and current mental health: A reanalysis of the National Comorbidity Survey using a common-risk-factors model

Using the US National Comorbidity Survey (NCS), Coleman, Coyle, Shuping, and Rue (2009) published an analysis indicating that compared to women who had never had an abortion, women who had reported an abortion were at an increased risk of several anxiety, mood, and substance use disorders. Here, we show that those results are not replicable. That is, using the same data, sample, and codes as indicated by those authors, it is not possible to replicate the simple bivariate statistics testing the relationship of ever having had an abortion to each mental health disorder when no factors were controlled for in analyses (Table 2 in Coleman et al., 2009). Furthermore, among women with prior pregnancies in the NCS, we investigated whether having zero, one, or multiple abortions (abortion history) was associated with having a mood, anxiety, or substance use disorder at the time of the interview. In doing this, we tested two competing frameworks: the abortion-as-trauma versus the common-risk-factors approach. Our results support the latter framework. In the bivariate context when no other factors were included in models, abortion history was not related to having a mood disorder, but it was related to having an anxiety or substance use disorder. When prior mental health and violence experience were controlled in our models, no significant relation was found between abortion history and anxiety disorders. When these same risk factors and other background factors were controlled, women who had multiple abortions remained at an increased risk of having a substance use disorder compared to women who had no abortions, likely because we were unable to control for other risk factors associated with having an abortion and substance use. Policy, practice, and research should focus on assisting women at greatest risk of having unintended pregnancies and having poor mental health—those with violence in their lives and prior mental health problems.     

孕妇感染解脲脲原体影响因素分析

对624例孕妇进行解脲脲原体(UU)感染因素分析。结果:职业、孕次和人工流产次数对UU感染影响较大。年龄、文化程度对孕妇UU感染影响不大。孕次和人工流产次数增加可能增加UU感染率,提示应加强对育龄妇女的生殖健康教育,避免意外妊娠,降低人工流产率。     

开展紧急避孕服务保护妇女身心健康

紧急避孕是避孕失败的一种有效补救措施,可有效降低人工流产率,对保护妇女身心健康有积极意义。我国紧急避孕服务尚不普遍,服务提供者和使用者的信息不足及缺乏可行的措施是目前存在的主要问题。通过以报纸为主要媒介的科普宣传后要求紧急避孕咨询和服务的人数明显增加,提示加强宣传是开展紧急避孕的基本措施。据统计,在加强宣传的四个月中,咨询电话的数目多达6000余次,1995年9月～1996年8月共为1000例妇女提供了紧急避孕服务,反映出群众对紧急避孕服务的迫切需求。建立热线电话也是便利群众和加强宣传的有效措施。在提供紧急避孕服务时根据紧急避孕服务使用者的特点,尊重其隐私权。对紧急避孕服务的咨询要点是,应说明所提供的紧急避孕服务方案的效果(失败率),可能的副反应及对下次月经的影响,对采用药物紧急避孕的妇女要强调本周期内用药后的避孕,并对今后常规避孕给予切实的指导。对进一步开展紧急避孕的建议包括:加强临床研究、筛选优选方案及促进紧急避孕获得性;以引入性试验方式推广紧急避孕服务及呼吁媒介加强对紧急避孕服务宣传等。     

Voluntary sterilization in Guatemala: a comparison of men and women

Report of a study comparing 500 men and 419 women who had undergone voluntary sterilization in Guatemala City, in terms of their sociodemographic characteristics, attitudes and motivations regarding the operation, reactions to the quality of attention received in the clinic, postoperative complaints, and the effect of the operation on health and sex life. In both groups over 90% reported no regret about the operation. Changes in health status or sex life after the operation emerged as very important correlates of satisfaction among both men and women. Acceptors tended to be married or live in consensual union, be Catholic but not very religious, have an average of 4 children, have used contraceptives prior to the operation (especially the pill), have a favorable attitude toward the attention received from clinic personnel, and report no change or a change for the better in their general health and sex life. However, the following differences did emerge between men and women: men were better educated and held more prestigious jobs; most men reported their wives to be in favor of their vasectomy, where 33% of the women said that their husbands had been indifferent; men were more likely to experience pain or discomfort in the 1st few days after the operation but less likely to lose time from work or lost fewer days (4.0 versus 5.5); among women, pain or discomfort with the operation was related to satisfaction--those experiencing pain were more likely to regret having had the operation; men, by contrast, were more likely than women to experience pain or discomfort, but this was not related to satisfaction with the operation a year or more afterwards. Recommendations include studying the effect of increased educational/promotional efforts among men with lower levels of education and more careful screening to detect individuals who may already be experiencing some type of sexual problem or have unrealistic expectations. Reasons for the higher rate of female sterilizations in Guatemala (15:1 or 5.7 tubal ligations to 1 vasectomy) include perceptions of less negative psychological consequences, attitudes of health practitioners, and use of the procedure on an outpatient basis. In general Guatemala has a low rate of family planning acceptance compared to surrounding countries.